Endometrial fluid collection in women with hydrosalpinx after human chorionic gonadotrophin administration: a report of two cases and implications for management.
The impact of hydrosalpinx (HSPX) on in-vitro fertilization (IVF) outcome has recently been the subject of intense debate. Most, but not all, studies have reported decreased implantation and pregnancy rates and increased early pregnancy loss in HSPX patients. This has led to prophylactic salpingectomies prior to IVF in HSPX patients despite the lack of any prospective studies to suggest that any improvement will occur. Women with HSPX constitute a heterogeneous population because some conceive easily with IVF while others do not until after surgical correction. HSPX also increases in size with ovarian stimulation, and can cause implantation failure by fluid reflux into the uterine cavity. Careful assessment of the endometrial lining is mandatory in HSPX to rule out fluid reflux from the HSPX. We present two case reports of patients whose HSPX enlarged with ovarian stimulation, causing fluid reflux into the uterine cavity which was only noted after human chorionic gonadotrophin (HCG) administration.
Sharara
F I
FI
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, USA.
McClamrock
H D
HD
D000328:Adult; D001826:Body Fluids / Q000502:physiology*; D006063:Chorionic Gonadotropin / Q000009:adverse effects*; D004624:Embryo Transfer; D004717:Endometrium / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D005184:Fallopian Tube Diseases / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D010062:Ovulation Induction / Q000009:adverse effects*; D011247:Pregnancy; D013396:Suction; D014463:Ultrasonography
D006063:Chorionic Gonadotropin